Current Anesthesiology Reports

, Volume 9, Issue 3, pp 223–233 | Cite as

Neurological Complications in Cardiac Surgery

  • Pascal A. Gerster
  • Anna Klesse
  • Julia Chang
  • Joachim M. Erb
  • Nicolai GoettelEmail author
Cardiovascular Anesthesia (J Fassl, Section Editor)
Part of the following topical collections:
  1. Cardiovascular Anesthesia


Purpose of Review

Perioperative neurological complications have a significant impact on mortality, morbidity, and quality of life in a growing number of high-risk patients undergoing cardiac surgery. In this comprehensive review, we provide an outline of the current literature with regard to stroke, perioperative neurocognitive disorders (delirium and cognitive decline), postoperative visual loss, and peripheral nerve injury in cardiac surgery.

Recent Findings

Cardiac surgeons, anesthesiologists, and critical care specialists are facing a new population of cardiosurgical patients who are older and sicker than in previous decades. If neurological complications occur during or after cardiac surgery, they may be devastating. We give insights into the etiology, underlying pathophysiologic mechanisms, incidences, and risk factors of these complications. Current international guidelines and preventive strategies are also discussed.


Despite technological and surgical progress aimed to reduce neurological injury in the perioperative period, neurological complications remain prevalent in cardiosurgical patients. An increased awareness of this problem will encourage appropriate risk management, frequent neurological assessments, and prompt therapeutic interventions.


Neurological complications Cardiac surgery Stroke Neurocognitive disorders Postoperative delirium Postoperative cognitive dysfunction Postoperative visual loss Peripheral nerve injury 



We thank Allison Dwileski, BSc, for proofreading the manuscript.

Compliance with Ethical Standards

Conflict of Interest

Pascal A. Gerster, Anna Klesse, Julia Chang, Joachim M. Erb, and Nicolai Goettel declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Pascal A. Gerster
    • 1
  • Anna Klesse
    • 1
  • Julia Chang
    • 1
  • Joachim M. Erb
    • 1
  • Nicolai Goettel
    • 1
    • 2
    Email author
  1. 1.Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital BaselUniversity of BaselBaselSwitzerland
  2. 2.Department of Clinical ResearchUniversity of BaselBaselSwitzerland

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